Reporting Workflow Rita Noumeir, Ph.D. IHE Technical Committee

Reporting WorkflowReporting WorkflowRita Noumeir, Ph.D.

IHE Technical Committee

HIMSS/RSNA Vendor Workshop, April 2003

IHE Integration ProfilesIHE Integration ProfilesScheduled Workflow

Admit, order, schedule,

manage worklists,

track status, perform &

notify acquisition

related steps,

create, store,

manage, retrieve &

use images

Simple Image and Numeric Reports

Create, store, manage, retrieve & use simple

diagnostic reports with optional image links &

measurements

Evidence Documents

Create, store, manage, retrieve & use objects to

record study evidence

Reporting Workflow

Manage worklists, track status, perform

& notify diagnostic

reporting steps

Required for workflow management

Required for content

Images or EDrequired for content

ChargePosting

Collect and post timely

billable procedure

details

triggers


Reporting Workflow Reporting Workflow ObjectivesObjectives

Schedule, distribute and track the status of reporting workflow tasks using standardized mechanisms– Worklists for each task are generated and

can be queried– Workitems can be performed and the

resulting status known and shared


Diagnostic report workflow

Reporting WorkflowReporting Workflow

AcquisitionModality

Image Manager& Archiveimages stored

acquisition completed

acquisition completed

images available

OF/DSS

work status update

Output:DICOM SR Objects


Actors & TransactionsActors & Transactions

No new actors

One new transaction:– Reporting Worklist Provided


Actors & TransactionsActors & Transactions

Report Manager

Report Creator/Reader

IM/IA

PPS Manager

DSS/OFReporting Worklist Provided

Workitem Claimed

Workitem PPS in Progress

Workitem PPS Completed

Workitem Completed

MPPS Completed

Image Availability

Procedure Scheduled

Procedure Update

P. Work Status Update


GroupingGrouping

Report Manager grouped with Image Manager

Report Manager

IM/IA

DSS/OF

Performed Work Status Update (optional)

RWF ProfileSWF Profile


GroupingGrouping

Report Manager grouped with DSS/OF

Report Manager

IM/IADSS/OF

RWF Profile

SWF Profile

Performed Work Status Update, if needed


GroupingGrouping

Report Manager not grouped with neither IM nor DSS

Report Manager

IM/IA

DSS/OF

Performed Work Status Update

RWF Profile

SWF Profile

SWF Profile

Performed Work Status Update, if needed


Reporting TasksReporting TasksThe process of report creation is

composed of multiple tasks:– Interpretation– Interpretation and dictation– Transcription– Verification– Review– Comparison– Coding


Verification vs SignatureVerification vs Signature

Verification is considered to be different from Signature

Verification may trigger a SignatureSignature has policies attached to it. Signature is not part of the Reporting

Workflow profile


Reporting Worklist ProvidedReporting Worklist Provided

Report Creator finds out what tasks have been scheduled or assigned to it by the Report Manager


Reporting Worklist ProvidedReporting Worklist Provided

General Purpose Worklist SOP Class Explicit definition of required matching and return

keys for both Report Manager and Report Creator

Report Creator implements at least one of Patient Oriented or User Oriented queries

Report Manager

Report Creator

C-Find-RQ

C-Find-RSP


Patient Oriented QueryPatient Oriented Query

Worklist for a specific patient/procedure

SCU shall support all combinations of the matching keys

Patient's Name

Patient ID

Referenced Request Sequence

>Accession Number

>Requested Procedure ID

Scheduled Workitem Code Sequence>Code Value

>Coding Scheme Designator


User Oriented QueryUser Oriented Query

Broad worklist for a particular user being logged in on a particular station

SCU must support all combinations of the matching keys

General Purpose Scheduled Procedure Step Status

Scheduled Station Name Code Sequence

>Code Value>Coding Scheme DesignatorScheduled Procedure Step Start Date and TimeScheduled Workitem Code Sequence

>Code Value>Coding Scheme DesignatorScheduled Human Performers Sequence>Human Performer Code Sequence>>Code Value >>Coding SchemeDesignator>Human Performer’s Name


Reporting Workitem CodesReporting Workitem Codes

DCMR CID 9231Coding Scheme

Designator

Code Value

Code Meaning

DCM 110005 Interpretation DCM 110006 Transcription DCM 110007 Report Verification DCM 110009 No subsequent Workitems


Reporting Workitem CodesReporting Workitem Codes

What is scheduled – GP Worklist: scheduled workitem code sequence

What is performed– GP PPS: Performed Work Item Code Sequence

What is next– GP PPS: requested subsequent workitems code

sequence

Update– what is performed, what is next


Input AvailabilityInput Availability

Report Manager uses Image Availability Query to know when images are available.

Report Manager and Report Creator must be able to handle workitems with PARTIAL Image Availability in a stable way.


Input InformationInput Information

Report Creator may retrieve Input Objects using Input Information Sequence provided in the worklist response.

Report Manager

Report Creator

C-Find-RQ

C-Find-RSP

IM/IA

Retrieve Images, Evidence Documents


Workitem ClaimedWorkitem Claimed

Report Creator takes ownership of the workitem Report Manager updates its worklist and permits

other worklist users to detect that this SPS has been claimed

General Purpose Scheduled Procedure Step SOP Class

Report Manager

Report Creator

N-ACTION, SPS in Progress


Workitem PerformedWorkitem PerformedProcedure Step In ProgressProcedure Step In Progress

Report Creator starts work on claimed SPS

General Purpose Performed Procedure Step SOP Class

SPS and PPS relationships – Simple Case - Unscheduled Case– Append Case - Abandoned Case

Report Manager

Report Creator

N-CREATE, PPS in Progress


Workitem PerformedWorkitem PerformedProcedure Step CompletedProcedure Step Completed


Report Creator notifies Report Manager of the PPS completion

Report Creator references any created results

Report Manager

Report Creator

N-CREATE, PPS Completed


Tasks PerformedTasks Performed

Report Creator may carry out several steps at once.

Performed Work Item Code Sequence General Purpose Performed Procedure Step

N-SET message.


Output GeneratedOutput Generated

Report Creator sends the list of all SOP Instances in the Output Information Sequence (0040,4033) or identifies non-DICOM output in the Non-DICOM Output Code Sequence (0040,4032).

General Purpose Performed Procedure Step N-SET message.


Next Workitem Next Workitem

The Report Creator may suggest subsequent workitems to the Report Manager.

It is a suggestion, a hint

The requested subsequent workitems code sequence

General Purpose Performed Procedure Step N-SET message.


Workitem CompletedWorkitem Completed

General Purpose Scheduled Procedure Step SOP Class

No further PPS will be created for this SPS Report Creator notifies the Report Manager

when it completes the scheduled workitem Report Manager updates its worklist

Report Manager

Report Creator

N-ACTION, SPS Completed


Performed Work Status Performed Work Status UpdateUpdate

Report Manager informs other actors of the creation and status update of the performed reporting task

Allows the systems not managing the performed work to stay in sync


Performed Work Status Performed Work Status UpdateUpdate


Performed Workitem Code Sequence Requested Subsequent Workitem Code

Sequence

Report Manager

DSS/OFIM/IA

N-CREATE, PPS in Progress

N-SET, PPS Completed


Diagnostic Reporting Use CasesDiagnostic Reporting Use Cases Predefined report Workitem deferred Direct report creation Interpretation and dictation Transcription Partial completion Verification Double reading, Comparison, Review, Over

read


Predefined reportPredefined report

The user chooses a report from a list of pre-configured draft reports

The results are normalI will also verify the report


Workitem deferredWorkitem deferred

The user starts to work on the workitem and decides not to complete it.

Put this workitem back on the worklist.


Partial CompletionPartial Completion

The user begins the task and then decides that this task cannot be completed at this moment.

Bad data quality! New acquisition is required


VerificationVerification

This use case has an extension when the user needs to correct the report's content by dictation

Send report back to the transcriptionist for correction


Questions?Questions?